Individual provider Active NPI

Tara Leigh Hart-Burhoop, PH.D., LP

  • Psychologist
  • Boys Town, NE
National Provider Identifier
1780064006
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
880 Issued in NE
Practice address
13460 Walsh Dr
Boys Town, NE 68010-7529
Phone
(402) 498-3358
Fax
(402) 498-3375
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 880 NE Primary

Addresses

Primary practice location

13460 Walsh Dr
Boys Town, NE 68010-7529

Mailing address

13460 Walsh Dr
Boys Town, NE 68010-7529
Phone (402) 498-3358

Other practice location 1

16929 Frances St Ste 101
Omaha, NE 68130-4684
Phone (531) 355-3358

Other identifiers 2

IdentifierTypeStateIssuer
10025550700MedicaidNE
47037660631MedicaidNE

Other names 1

  • Tara Leigh Hart Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150916002831 NE Practitioner - Clinical Psychologist 8921315367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18021 Oak St
Suite B
Omaha, NE 68130-6035
Phone (402) 986-6250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home CurrentSince Aug 3, 2015 Accepting new patients
Perspective Behavioral Health Psychologist CurrentSince Sep 29, 2022 Accepting new patients

Locations

13460 Walsh Dr
Boys Town, NE 68010
Phone (531) 355-3358

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

16929 Frances St
Ste 101
Omaha, NE 68130
Phone (402) 758-5125

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

18021 Oak St
Ste B
Omaha, NE 68130
Phone (402) 986-6250

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1780064006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "402-498-3358",
            "fax_number": "402-498-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "402-498-3358",
            "fax_number": "402-498-3375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16929 Frances St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681304684",
            "country_code": "US",
            "telephone_number": "531-355-3358",
            "fax_number": "531-355-3375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART-BURHOOP",
        "first_name": "TARA",
        "middle_name": "LEIGH",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025550700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HART",
            "middle_name": "LEIGH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boys Town, NE

Sources for this page

Verify at the official NPI Registry.